Molecular Characterization of Mycobacterium Tuberculosis in HIV Patients Receiving Antiretroviral Drugs in Cameroon.

IF 1.6 Q4 INFECTIOUS DISEASES
International Journal of Mycobacteriology Pub Date : 2025-04-01 Epub Date: 2025-06-20 DOI:10.4103/ijmy.ijmy_47_25
Gerades Dely Djoufack, Lem Edith Abongwa, Allan Olayemi Campbell, Julian Sydney Olufemi Campbell, Kabir Gorden, Jean M Mendimi Nkodo, Christian Happi, Onikepe Folarin
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引用次数: 0

Abstract

Background: Tuberculosis (TB) remains a leading cause of mortality among people living with HIV/AIDS, who face a tenfold higher risk of Mycobacterium tuberculosis (MTB) infection. TB-HIV coinfection complicates disease management due to drug interactions, overlapping toxicities, immune reconstitution inflammatory syndrome, and high treatment burdens, potentially driving drug resistance. The emergence of resistant MTB further exacerbates this challenge. This study evaluated the drug resistance profile of MTB in TB-confirmed samples from HIV-positive patients.

Methods: An analytical cross-sectional study was conducted on 216 sputum samples from HIV patients on antiretroviral therapy at Jamot Hospital, Yaoundé, Cameroon (June-September 2022). Two consecutive samples per patient underwent fluorescent microscopy (Auramine-Rhodamine stain) and TB-Loop-Mediated Isothermal Amplification. DNA was extracted using the GenoLyse® kit (Hain Lifescience, Germany), and drug resistance profiles were assessed via GenoType® MTBDRplus and MTBDRsl line probe assays.

Results: TB was confirmed in 12.04% (26/216) of participants. Rifampicin (RIF) and isoniazid (INH) resistance were each detected in 50% (13/26) of cases, with 23% (6/26) exhibiting multidrug-resistance (MDR). Predominant mutations included rpoB MUT2B (15.38%) for RIF and inhA MUT2A (23.06%) for INH. Second-line resistance analysis revealed 61.54% (8/13) resistance to kanamycin (KAN)/amikacin (AMK)/viomycin, 7.69% (1/13) to AMK/capreomycin/viomycin, and 7.69% (1/13) to KAN. Notably, 61.54% (8/13) lacked the rrs wild-type probe, indicating resistance to injectable TB drugs.

Conclusion: High MDR-TB prevalence was observed among HIV-TB coinfected patients, underscoring the urgent need for enhanced resistance surveillance and optimized treatment strategies in TB/HIV-endemic regions like Cameroon. Further research is warranted to elucidate HIV's role in driving TB drug resistance.

喀麦隆接受抗逆转录病毒药物治疗的艾滋病毒患者结核分枝杆菌的分子特征
背景:结核病(TB)仍然是艾滋病毒/艾滋病感染者死亡的主要原因,这些人感染结核分枝杆菌(MTB)的风险高出10倍。由于药物相互作用、重叠毒性、免疫重建炎症综合征和高治疗负担,结核病-艾滋病毒合并感染使疾病管理复杂化,可能导致耐药性。耐药MTB的出现进一步加剧了这一挑战。本研究评估了来自hiv阳性患者的结核确诊样本中MTB的耐药概况。方法:对2022年6月至9月在喀麦隆雅温德省Jamot医院接受抗逆转录病毒治疗的艾滋病毒患者的216份痰样本进行分析性横断面研究。每位患者连续两次进行荧光显微镜检查(Auramine-Rhodamine染色)和tb - loop介导的等温扩增。使用GenoLyse®试剂盒(Hain Lifescience,德国)提取DNA,并通过GenoType®MTBDRplus和MTBDRsl系探针检测评估耐药谱。结果:结核确诊率为12.04%(26/216)。50%(13/26)的病例对利福平(RIF)和异烟肼(INH)耐药,23%(6/26)的病例为多药耐药。主要突变包括RIF的rpoB MUT2B(15.38%)和INH的inhA MUT2A(23.06%)。二线耐药分析显示,卡那霉素(KAN)/阿米卡星(AMK)/viomycin耐药率为61.54% (8/13),AMK/卷曲霉素/viomycin耐药率为7.69% (1/13),KAN耐药率为7.69%(1/13)。值得注意的是,61.54%(8/13)的人缺乏rrs野生型探针,表明对结核病注射药物有耐药性。结论:在HIV-TB合并感染患者中观察到高耐多药结核病患病率,强调迫切需要加强耐药性监测和优化结核病/艾滋病毒流行地区(如喀麦隆)的治疗策略。需要进一步的研究来阐明艾滋病毒在驱动结核病耐药性中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.20
自引率
25.00%
发文量
62
审稿时长
7 weeks
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